Did an injury or illness (sore
throat, diarrhea, or flu-like symptoms) occur before the symptoms started, or
did the symptoms come on slowly over time?

Has the child been
bitten by a tick that may be a carrier of
Lyme disease?

Are there other symptoms
(such as fever, fatigue, or rash) that occurred before or with joint
symptoms?

The physical exam generally is not painful and
includes:

Checking body temperature, blood pressure,
lymph nodes, and joints.

Examining the heart and lungs with a
stethoscope.

Feeling the abdomen.

Examining the
skin.

Why It Is Done

A history and physical exam are a routine part of the
evaluation of joint pain and stiffness. JIA is diagnosed only after a careful
physical exam and medical history.

Joints affected by JIA are often stiff in the
morning and improve as the child uses the joint.

Children usually
bear weight on a joint affected by JIA despite the swelling.

Joints affected by JIA tend to be less painful than those affected
by other conditions, such as infection, injury, or cancer.

Results

During the physical exam, the doctor will
note:

Joint problems, such as swelling, tenderness,
or stiffness.

The number and location of affected
joints.

Whether there are other symptoms (fever, rash, or
fatigue).

Using the above information, your doctor may be able
to clarify the diagnosis and the type of JIA. In many cases, your
child may have symptoms for up to 6 months before the type of arthritis is
diagnosed.

What To Think About

The diagnosis of juvenile idiopathic arthritis (JIA) requires
ruling out other conditions. Information from the medical history and physical
exam is very important to evaluate possible causes of symptoms and to
select the best tests to rule out other conditions.

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